Robert Graves Lecture 2002_Dr. Gerald H Tomkin

27/06/2002 in Royal College of Physicians of Ireland, 6, Kildare Street, Dublin 2

Gerald H Tomkin, Department of Medicine, The Adelaide and Meath Hospital, Trinity College, Dublin

Diabetes and atherosclerosis – a gut review

The physician Robert Graves stands head and shoulders above all other Irish physicians, at least to someone interested in metabolic medicine. He was attached to both the Meath and the Adelaide Hospitals and his interest in metabolism is clearly demonstrated in the words he wished to have on his grave: `He fed fevers’.

This memorial lecture allows me the opportunity of reviewing the importance of the bowel in the regulation of lipoprotein metabolism in diabetes. This field has taken on particular importance with the knowledge that diabetes is becoming an enormous health problem throughout the world due to the increase in the number of people with the condition and also the frequency with which the complications of diabetes occur. Cardiovascular disease is up to four times more common in people with diabetes. The life span of people with diabetes is reduced by, on average, eight years. The younger the patient the more obvious this reduction. It has only recently been realised by the government that diabetes, and particularly the complications of diabetes, take up about 10% of the total health budget. The cardiovascular health strategy, a large document produced by the government setting forward a programme to improve the cardiovascular health of the country, contains only five lines about diabetes, yet up to 50% of patients in the coronary care unit have diabetes or impaired glucose tolerance.

Irish J Med Sci April 2002, Volume 171, Issue 2, pp 105–109

This being the forty-second Graves Lecture since its beginnings in 1961.